Indian Journal of Surgery

, Volume 77, Supplement 3, pp 1301–1307 | Cite as

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

  • Marcello PicchioEmail author
  • Ettore Greco
  • Annalisa Di Filippo
  • Giuseppe Marino
  • Francesco Stipa
  • Erasmo Spaziani
Review Article


Surgical therapy guaranties satisfactory results, which are significantly better than those obtained with conservative therapies, especially for Grade III and IV hemorrhoids. In this review, we present and discuss the results of the most diffuse surgical techniques for hemorrhoids. Traditional surgery for hemorrhoids aims to remove the hemorrhoids, with closure (Fergusson’s technique) or without closure (Milligan–Morgan procedure) of the ensuing defect. This traditional approach is effective, but causes a significant postoperative pain because of wide external wounds in the innervated perianal skin. Stapled hemorrhoidopexy, proposed by Longo, has gained a vast acceptance because of less postoperative pain and faster return to normal activities. In the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported, when compared with conventional hemorrhoidectomy. Double stapler hemorrhoidopexy may be an alternative to simple stapled hemorrhoidopexy to reduce the recurrence in advanced hemorrhoidal prolapse. Transanal hemorrhoidal deartertialization was showed to be as effective as stapled hemorrhoidopexy in terms of treatment success, complications, and incidence recurrence. However, further high-quality trials are recommended to assess the efficacy and safety of this technique.


Hemorrhoids Surgery Indication Resection Stapler 


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Copyright information

© Association of Surgeons of India 2014

Authors and Affiliations

  • Marcello Picchio
    • 1
    • 4
    Email author
  • Ettore Greco
    • 1
  • Annalisa Di Filippo
    • 3
  • Giuseppe Marino
    • 1
  • Francesco Stipa
    • 2
  • Erasmo Spaziani
    • 3
  1. 1.Department of SurgeryCivil Hospital “P. Colombo”RomeItaly
  2. 2.Department of SurgeryHospital “S. Giovanni-Addolorata”RomeItaly
  3. 3.Department of SurgerySapienza University of RomeLatinaItaly
  4. 4.LatinaItaly

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